Hirsutism – Causes of Abnormal Hair Growth in Females

What is hirsutism?

Hirsutism is the medical name of a condition which is characterized by excessive growth of hair in areas of the body that normally have fine hair or sparse hair growth. This condition can occur in both men and women. In hirsutism, the hair growth pattern in women is like that of a male. For example, women with hirsutism have hair growth on chest, back, abdomen, and face. These body areas normally have very fine hairs in women. The thick hair growth in hirsutism is caused by abnormally high levels of male hormones known as androgens.

Excessive Body Hair in Men and Women

Body hair is present in both males and females. However, the characteristics of hair growth are very different in both the sexes. For example, males have thick facial hair (beards and mustaches), whereas thick facial hair growth in females is considered to be abnormal. It is important to note that facial hair is not entirely absent in females. However, the facial hair in females is finer when compared to the facial hair in males.

The difference in the patterns of hair growth in males and females are caused by the activities of the male and female sex hormones. Androgens are the male hormones that cause the growth of thick hair in males. The sex-specific patterns of hair growth become apparent after puberty. This is the time when male and female sex hormone production begins to affect the characteristics of hair growth all over the body.

The pattern of hair growth that is established at the time of puberty continues till adulthood. The fine, downy body hair present in early childhood is known as vellus hair. After puberty, the vellus hair gives way to terminal hair. Excessive hair growth all over the body is referred to as hypertrichosis. Hirsutism is different from hypertrichosis in terms of the hair growth pattern. In hirsutism, there is an androgenic hair growth pattern in both males and females.

Causes of Thick Hair Growth in Females

The thick hair growth in a male pattern is dictated by the androgens (male sex hormones). Females contain both female and male sex hormones. However, the level of androgens in females is significantly lower than in males. In hirsutism, the level of androgens in females increases, resulting in terminal hair growth that is similar to that in males. An increased level of androgens may also result in hair loss in both sexes. Hirsutism could also result from an increased sensitivity of the hair follicles to the stimulatory effect of androgens.

The following conditions may cause thick hair growth or hirsutism in females.

Polycystic ovarian syndrome

One of the most common causes of hirsutism in females is polycystic ovarian syndrome (abbreviated as PCOS). This condition is characterized by the presence of multiple cysts on the ovaries. Polycystic ovarian syndrome can affect either one or both the ovaries. There is an increased production of androgens in polycystic ovarian syndrome, which results in the growth of thick hair on the body and face. Other adverse effects of polycystic ovarian syndrome may include menstrual pain, irregular menstrual cycle, lower abdominal pain, obesity, premenstrual syndrome, impaired glucose tolerance and infertility.

Read more on signs of PCOS.

Disorders of the adrenal glands

The adrenal gland is one of the sources of androgens. The production of androgens may increase in certain disorders of the adrenal glands, resulting in thick hair growth on the body and face. Examples of some adrenal disorders that may lead to hirsutism include Cushing’s syndrome, Addison’s disease, congenital adrenal hyperplasia and tumors of the adrenal glands.

Familial hirsutism

A genetic predisposition to hirsutism or excessive hair growth is sometimes seen to run in families and certain ethnic groups. Genetic factors may cause the hair follicles to have increased sensitivity to androgens, causing terminal hair growth on abdomen, thighs, arms and face.


Androgen levels may also increase in the blood due to certain drugs. Examples of drugs that may cause increased androgen levels and hair growth include anabolic steroids, contraceptives with high progesterone content, drugs used for hormone replacement therapy, and drugs used for the treatment of endometriosis.

Hormonal changes

In women, hormonal changes that occur during pregnancy and menopause can lead to hirsutism.

Disorders of endocrine glands

Androgen levels in the body can increase due to various disorders of the endocrine glands. Disorders of the thyroid gland, pituitary gland, pancreas, and sex glands can cause increased androgen levels in the blood, which can lead to hirsutism.


Increased production of androgens and other hormones can also occur due to the presence of tumors. Hormone-producing tumors that stimulate hair growth can occur both within and outside the sex glands.

Facial Hair Removal for Females

Thick facial hair is a disturbing cosmetic problem for women. Normally, facial hair in women is very fine and almost invisible. In hirsutism, the growth of thick, terminal facial hair is patently visible as fine mustache and beard. In the majority of cases, however, this facial hair is not as thick or extensive as in males.

For example, the beard region in hirsute females may only have a few strands of visible hair rather than a fully grown beard that is characteristic of males. Treatment of hirsutism depends on the identification of the underlying cause of hair growth in females. In cases where the underlying cause is unknown (idiopathic cases), various hair removal or hair masking techniques can be used to improve the cosmetic appearance.

Some common hair removal (or epilation) techniques include waxing, plucking (using tweezers), hair removal creams, shaving, electrolytic hair removal, and laser hair removal. Bleaching is frequently used to mask the facial hair. This technique works by lightening the color of the hair, so that the hair does not stand out against the skin on the face.

The hair removal or hair masking techniques are not permanent remedies for hirsutism. These procedures need to be repeated at regular intervals in order to maintain an acceptable cosmetic appearance. Caution should be exercised while using any hair removal technique since folliculitis and staph skin infections may occur in some cases.

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